The present invention relates to an internal anchoring device and, more particularly, to a percutaneous obturatable internal anchoring device for use with various gastrostomy tubes.
For example, numerous medical conditions exist in which it becomes necessary to gain percutaneous access to viscera such as the stomach. Situations where a patient has lost the ability to swallow and will require long term nutritional support may dictate feeding directly through the stomach. This type of feeding may be accomplished by inserting a feeding tube into the patient's stomach such that one end remains anchored in the stomach, while the other end remains external to the patients's body for connection to a nutrient source.
Feeding tubes may be inserted into a patient's stomach in a number of ways. One preferred method involves an endoscopic procedure whereby an endoscope is advanced through a patient's mouth, down the esophagus and into the stomach. A suture, which is inserted through a stoma in the abdomen wall, is attached to the endoscope. The endoscope is then withdrawn back up the esophagus and out of the patient's mouth. At this point, the suture is attached to a loop of filament wire included on the end of the feeding tube. The feeding tube is then "pulled" down the esophagus, into the stomach and out of the stoma in the abdomen wall.
Next, the physician grasps the tube and withdraws the remainder of the tube until the end of the tube, which includes some type of internal anchoring device, contacts the internal wall of the stomach. The anchoring device prevents the tube from being fully withdrawn from the stomach. The feeding tube is then secured to the individual by, for example, fitting a retention disk over the tube protruding outward from the stomach and positioning such disk into contact with the outer abdomen wall.
A feeding tube can also be placed into the stomach by "pushing" such tube down the esophagus over a previously-positioned guidewire. Moreover, a feeding tube or other gastrostomy tube may be positioned into the stomach through an existing stoma in the abdomen wall.
It is the design of the internal anchoring devices of the prior art that create many of the problems associated with gastrostomy tubes. For example, the anchoring capability of many of the prior art devices is less than desirable, resulting in inadvertent patient removal of the tube. Additionally, the anchoring device of the prior art units typically have a dome or mushroom shape, which provides a device with a relatively large profile, thus leading to patient discomfort or worse, hemorrhaging, during the removal procedure. Additionally, the prior art units are susceptible to clogging during introduction/removal of fluids/gases. Units having a mushroom-shaped anchoring device are particularly susceptible to clogging. Finally, the units of the prior art typically hinder the insertion and placement of auxiliary devices, e.g., jejunal tubes, which are inserted through the previously positioned gastrostomy tube and advanced into the small intestine.